The effect of intestinal and vaginal microflora on the risk of premature birth in pregnant women with a short cervix

Objective. To study the effect of the microbiota of the vagina and intestines on the risk of premature birth in pregnant women with a short cervix. Materials and methods. 130 patients with a cervical length of 2.5 cm or less were examined during pregnancy and after childbirth, among whom two groups were formed: 1st (main) — 68 patients who gave birth prematurely and the 2nd (control) — 62 patients who gave term birth. The assessment of the vaginal microflora was carried out by polymerase chain reaction in real time. The parameters of the colon microflora were studied using culture and mass spectrometric methods. Results. Patients in group 1 were more likely to have a decrease in the total number of Lactobacilli in the vaginal contents (χ2=10.94; p=0.0005; OR=3.93; 95% CI — (1.8—8.7)), statistically significant differences were found between the studied groups in the frequency of detection of Gardnerella vag. (χ2=16.8; p=0.00002; OR=6.6 DI (2.6—16.5), and Atopobium vag. (χ2=8.5; p=0.001; OR=3.92 CI (1.6—9.5)). In the study of intestinal microflora, conditionally pathogenic microorganisms of facultative anaerobic origin S. aureus were statistically significantly more common in patients of the 1st group. (p=0.04) and Cl. pneumoniae (p=0.02), with a higher number of colony -forming units. At the same time, there was a decrease in lactobacilli (p=0.009) and obligate anaerobic bacteria of the Bacteroidaceae family (p=0.044). Based on the results of the study of the microbiocenosis of the vagina and intestines, a prognostic model for assessing the risk of premature birth in women with a short cervix was developed, which had a very good diagnostic value and statistical significance (AUC=0.834; p<0.0001). Conclusion. The determination of the microbial composition of the vagina and intestines will significantly improve the prognosis of premature birth in pregnant women with a short cervix.